title: Framing quality improvement tools and techniques in healthcare the case of improvement leaders' guides.
abstract: OBJECTIVE
  The purpose of this paper is to present a study of how quality improvement tools and techniques are framed within healthcare settings.
  
  
  METHODS
  The paper employs an interpretive approach to understand how quality improvement tools and techniques are mobilised and legitimated. It does so using a case study of the NHS Modernisation Agency Improvement Leaders' Guides in England.
  
  
  RESULTS
  Improvement Leaders' Guides were framed within a service improvement approach encouraging the use of quality improvement tools and techniques within healthcare settings. Their use formed part of enacting tools and techniques across different contexts. Whilst this enactment was believed to support the mobilisation of tools and techniques, the experience also illustrated the challenges in distributing such approaches.
  
  
  CONCLUSIONS
  The paper provides an important contribution in furthering our understanding of framing the "social act" of quality improvement. Given the ongoing emphasis on quality improvement in health systems and the persistent challenges involved, it also provides important information for healthcare leaders globally in seeking to develop, implement or modify similar tools and distribute leadership within health and social care settings.
authors.affiliation: Health Services Management Centre, University of Birmingham, Birmingham, UK. r.millar@bham.ac.uk
authors.forename: Ross
authors.initials: R
authors.lastname: Millar
mesh_terms: D004739:England; D006801:Humans; D007857:Leadership; D019982:Organizational Case Studies; D009936:Organizational Innovation; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D013222:State Medicine / Q000458:organization & administration* / Q000592:standards / Q000639:trends